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General NPI Number Information
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NPI Number | 1407033137
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Entity Type | Organization
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Legal Business Name | SMILE CREATIONS, P. C.
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Dates
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Enumeration Date | 01/24/2008
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Last Update Date | 02/04/2010
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Provider Practice Location Address
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Address Line | 6907 W. BOEING DR
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City | MIDWEST CITY
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State | OK
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Zip | 73110
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Country | US
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Telephone | 405-455-2552
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Fax | 405-455-2553
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Provider Business Mailing Address
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Address Line | 6907 W. BOEING DR
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City | MIDWEST CITY
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State | OK
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Zip | 73110
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Country | US
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Telephone | 405-455-2552
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Fax | 405-455-2553
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Authorized Official
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Title or Position | DENTIST
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Name | DR. ANTHONY T NGUYEN
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Credential | D.D.S.
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Telephone | 405-455-2552
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 5287
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License Number State | OK
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